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Abstract:

Human pain perception is now known to be mediated by the complex and dynamic
interaction of biological and psychosocial systems. Research with both clinical and nonclinical
populations has identified an array of factors which can influence pain, amongst
which gender has become the focus of increased interest in recent years. However,
although females generally seem to have lower experimental pain thresholds, report
higher levels of pain and demonstrate lower pain tolerance than males, the pain research
literature is characterised by conflicting findings regarding the direction, magnitude and
robustness of such gender effects. Furthermore, gender differences may not occur
equally with all types of noxious stimuli.
Investigating the impact of gender on pain is greatly complicated by the fact that gender
in itself comprises both biological and psychological components. Gender-differentiated
pain responses are therefore likely to involve physiological mechanisms such as the
effects of gonadal hormones, as well as psychosocial determinants such as emotional
responses and ways of coping. In this thesis, a series of controlled experiments was
conducted to investigate the effects of gender and cognitive coping on cold pressor pain
perception in healthy, pain-free individuals. The cold pressor paradigm was selected
because relatively few previous studies have directly examined gender differences in
this type of experimentally-induced pain. In light of potential fluctuations in female
pain sensitivity as a function of hormonal status, cold pressor responses and the
effectiveness of cognitive coping were also investigated in different phases of the
menstrual cycle.
Gender differences in pain responses were evident here, but such differences occurred
inconsistently across the series of experiments. Cognitive coping was found to have
very limited impact overall, and no effects of menstrual phase were found on pain
responses or on coping. These findings are discussed within a biopsychosocial
framework of pain perception.